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Pediatric Nephrology

, Volume 11, Issue 4, pp 508–512 | Cite as

Renal problems in black South African children*

  • Peter D. Thomson
Occasional survey

Abstract.

Black South African children have an increased prevalence of acute post-streptococcal glomerulonephritis, focal glomerulosclerosis, hepatitis B-associated membranous nephropathy, congenital syphilis, congenital nephrotic syndrome with Alport-like basement membrane changes and Takayasu’s arteritis, but a paucity of reflux nephropathy, polycystic kidney disease and non-shigella-induced haemolytic uraemic syndrome. However, in recent years, the haemolytic uraemic syndrome has become more prevalent in black children; this is usually due to Shigella dysenteriae type 1, and could indicate a different emphasis in the pathogenic mechanism. Focal glomerulosclerosis is the commonest reason for renal failure requiring transplantation in black children with rapidly progressive glomerulonephritis (usually streptococcal induced) being second. Transplantation has been somewhat problematic with a scarcity of kidneys at times, many mismatches and poor compliance in the lower socio-economic groups. The association of tuberculosis with focal glomerulosclerosis and Takayasu’s arteritis in black South African children is intriguing. The progression of focal glomerulosclerosis is accelerated in those patients with evidence of previous tuberculosis, and in Takayasu’s arteritis the association is almost absolute as experienced locally, with the data suggesting an autoimmune reaction.

Key words: Black South African children Acute post-streptococcal glomerulonephritis Nephrotic syndrome Takayasu’s arteritis Shigella dysenteriae type 1 Haemolytic uraemic syndrome Renal transplant 

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Copyright information

© IPNA - International Pediatric Nephrology Association New York, USA 1997

Authors and Affiliations

  • Peter D. Thomson
    • 1
  1. 1.Division of Paediatric Nephrology, University of the Witwatersrand, Ward 296, Johannesburg Hospital, Private Bag X39, Johannesburg 2000, South AfricaZA

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